After a healthy childhood, my best friend suddenly started having breathing difficulties when she was 20 years old. The doctor diagnosed her with asthma. With the help of inhaled medications, she was able to control her symptoms. But a year later, the medications were no longer effective and she started having monthly, life-threatening asthma attacks. The severe attacks became more frequent a few days before her menstrual period, and the symptoms disappeared days after her period ended. At that time, I wondered if hormones could be to blame.
As a graduate student investigating the role of male and female hormones in lung inflammation, I know now that asthma can be a hormone-related health issue. Unfortunately, many people are unaware of this relationship. Hormones are chemicals that travel as messengers around the body through the bloodstream. They affect many bodily functions and play a large role in a woman’s life cycle from birth through puberty, adulthood, pregnancy and menopause. In proper balance, hormones help the body communicate and thrive. But sometimes hormone levels can be too high or too low, causing serious health problems, especially in people with asthma.
Although more young boys have asthma than girls, the pattern is reversed in adults: More women have asthma than men. During puberty girls begin to produce higher levels of the sex hormones estrogen and progesterone, which rise and fall throughout their menstrual cycle. About one-third of females with asthma report premenstrual-related asthma symptoms, which may lead to severe attacks. A research study of girls ages 8 to 17 found that those who started menstruating at earlier ages developed more severe asthma after puberty, perhaps because their hormone levels began to change earlier in life. Studies have shown that hormonal changes can disturb the airways and inflammatory responses in the lungs. As hormone levels go up and down, new blood vessels in the lungs form and disappear, affecting the lungs’ ability to take in oxygen. In addition, female hormones do not just cause breathing problems in women with asthma, but also in those who smoke or are overweight.
Researchers are working to discover how sex hormones affect the lungs in order to develop personalized treatments for asthma. Ideally, specialized treatments in the future will be gender-specific and take into consideration a person’s hormonal status.
Nathalie Fuentes is a PhD candidate in the biomedical sciences program at Penn State College of Medicine. Her studies in Dr. Patricia Silveyra’s lab include the development of sex-specific therapies to treat lung diseases, sex differences in asthma-related lung inflammation triggered by ground-level ozone and the role of male and female sex hormones in lung disease. Nathalie is originally from Caguas, Puerto Rico.